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The Quest For Universal
Ken Frisof, M.D., Tom Paine
October 20, 2005
Dr. Ken Frisof is the national director of the Universal Health Care Action Network (UHCAN) and a practicing family physician with the public hospital in Cleveland. UHCAN is holding its 14th annual National Conference in Arlington, Va., at the Sheraton Crystal City, October 21-23.
Many in the progressive community see advocacy for universal health care as quixotic at best, futile at worst. Alone among economically advanced nations, the United States does not guarantee access to affordable health care to all in this country. Six times in the last century, progressives mounted campaigns for universal health care and came up with nothing. Now, conservative Republicans control all three branches of the federal government, and President Bush is demonstrating his skill at the Reagan strategy of "strategic budget deficits," such as paying for Katrina clean-up with budget cuts in key programs for the needy.
Health care in the United States, as an article in The New York Times noted last week, is "fragmented and profit-driven, a system in which everyone but the patient is meant to benefit financially." For the past 50 years, health spending has risen 2 percent faster than the GDP just about every year, so that health care now accounts for one dollar out of every six in the economy. Much of this spending is wasted on administrative costs or clinical procedures with little benefit. As the GM worker and retiree health insurance givebacks this week demonstrate, there are very few Americans with secure affordable coverage. The problem of underinsurance is growing even more rapidly than the number of the uninsured.
The failures of health reform in the Clinton era pushed many into purely defensive modes or into supporting small and piecemeal changes. But in the aftermath of the 2004 elections, a growing group of advocates is taking a new look at how to move forward.
Health justice advocates, along with much of the progressive community, are exploring how to frame the big health care issues more convincingly, recognizing that we need to move beyond complex technical policy language into the domain of broad values. This weekend, the Universal Health Care Action Network is convening health justice advocates to discuss how to move America toward affordable health for all.
One of the highlights of the UHCAN Conference is a Friday afternoon session that will address how we frame health care issues. The political strategist and pollster Celinda Lake will use fresh data to highlight public receptivity to major change.
New coalitions are forming, breathing new life into the campaign for universal health care. One of the few good pieces of the Medicare law passed by Congress in 2003 created a new opportunity for education on the core issues in health care. One section of the law set up the Citizens Health Care Working Group , which includes representatives from the labor, academic and corporate sectors.
The Working Group is beginning a six-month period seeking public input on the problems in American health care and how to fix them. To take advantage of this new opportunity to address the fundamental questions of what is wrong with American health care, a group of 12 organizations-including health care providers, faith communities, labor and justice advocates-has organized the "Making Health Care Work for All " campaign.
Michael Shellenberger and Ted Nordhaus, coming out of the environmental movement, have called on progressives to develop new values-based strategic initiatives based on a deeper understanding of American values.
In the health care community, thinking along these lines is accelerating. As described in a new DVD produced by UHCAN entitled Affordable Health Care for All: Moving Beyond Political Deadlock , the obstacles that have prevented the U.S. from finding our own special path to universal health care are moral, ideological and political.
There's hope in the policy direction promoted by the late Sen. Paul Wellstone-a federal-state partnership strategy-for moving us "beyond political deadlock." The potential for broad appeal of this strategy is highlighted by its support from across the ideological spectrum. Henry Aaron of the Brookings Institution, who is speaking at the conference's Saturday lunch plenary, has teamed up with Stuart Butler of the Heritage Foundation to talk about this approach at academic conferences, Senate committee hearings, and the National Governors Association.
The sick state of American health care was a key issue in the 1992 election cycle. Since then, although the patient has gotten sicker, politicians have mostly paid attention to minor symptoms, offering tiny bits of symptomatic relief rather than a cure. The advocacy community knows we have to do better. The organizing and education opportunities, the new alliances being developed, and the attention to new strategic initiatives have the potential to make the 2008 election cycle different. For the first time in 16 years, if we do our work well, the nation and its candidates will be forced to grapple honestly with the causes of our health care disease and propose real cures.
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